| Miss Imelda Tividad Russell, CRNP | |
|
6510 Kenilworth Ave Ste 2500, Riverdale, MD 20737-1346 | |
| (410) 997-1907 | |
| Not Available |
| Full Name | Miss Imelda Tividad Russell |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 26 Years |
| Location | 6510 Kenilworth Ave Ste 2500, Riverdale, Maryland |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528163540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LA2200X | Nurse Practitioner - Adult Health | AC000309 (Maryland) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Adventist Healthcare White Oak Medical Center | Silver spring, MD | Hospital |
| Umd Prince George's Hospital Ctr | Cheverly, MD | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Imran H Chowdhury Md Pa | 3274554126 | 14 |
| Imran H Chowdhury Md Pa | 3274554126 | 14 |
| Entity Name | Imran H Chowdhury Md Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699728089 PECOS PAC ID: 3274554126 Enrollment ID: O20051213000791 |
| Entity Name | Premier Health Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285017822 PECOS PAC ID: 7618285842 Enrollment ID: O20151008000494 |
| Mailing Address | Practice Location Address |
|---|---|
| Miss Imelda Tividad Russell, CRNP 6510 Kenilworth Ave Ste 2500, Riverdale, MD 20737-1346 Ph: (109) 971-9074 | Miss Imelda Tividad Russell, CRNP 6510 Kenilworth Ave Ste 2500, Riverdale, MD 20737-1346 Ph: (410) 997-1907 |
Basil E Fomanka, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6200 Baltimore Ave, 300-r9, Riverdale, MD 20737 Phone: 443-520-8138 | |
Akunna Chisom Ikocha, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6801 Kenilworth Ave Ste 300, Riverdale, MD 20737 Phone: 240-838-6354 | |
Saritha Sudharsun, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6516 Rosalie Ln, Riverdale, MD 20737 Phone: 240-367-3759 | |
Marian Kolb Jones, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5711 Sarvis Ave, Suite 200, Riverdale, MD 20737 Phone: 301-277-8100 Fax: 301-277-0668 | |
Binnur Genc, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6510 Kenilworth Ave Ste 2500, Riverdale, MD 20737 Phone: 410-997-1907 | |
Bosede M Adeleye, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6801 Kenilworth Ave Ste 300-s2, Riverdale, MD 20737 Phone: 301-512-9449 Fax: 301-798-6260 |